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Apr 09, 2017

Need help with seal rings not sealing on abdomen - how to protect skin around stoma?

This topic is about finding ways to protect the skin around an inverted stoma, especially when the seal ring doesn't adhere properly, leading to leaks and skin irritation. Here are some helpful tips and advice shared by others who have faced similar challenges:

1. Skin Preparation:
- Use yellow Original Dial soap or Ivory soap, as they are oil- and perfume-free.
- Make sure the skin is completely dry before applying any products. Avoid changing in a steamy bathroom.
- Apply a skin-prep or barrier wipe. Some people recommend Coloplast Skin Prep wipe #2041 or Cavilon brand wipes.

2. Product Layering and Build-up Techniques:
- Consider using a convex wafer to help press the area outward. Alternatively, build a flat surface first and then apply a flat wafer.
- Fill in any hollows with stoma paste or pieces of an Eakin Cohesive ring. Smooth the paste with a wet finger.
- Warm half or full barrier rings with a hair dryer before placing them for better adhesion.
- Hold the wafer or bag in place for about 60 seconds and use an ostomy belt temporarily to reinforce the seal.

3. Alternate Pouching Systems:
- Try a 1-piece appliance; some have had success with Convatec 1-piece bags.
- Use flanges specifically designed for inverted stomas if they are available.
- If you suspect a batch of flanges is defective, contact the manufacturer for replacements.

4. Protecting Damaged or Weeping Skin:
- Use the encrustation method: dab a barrier wipe, sprinkle stoma powder, and tap with another wipe to form a "crust." Repeat for very sore areas before applying the appliance.

5. Sampling and Troubleshooting:
- Request free samples of various barriers, rings, wafers, pastes, and wipes from different manufacturers to find the best fit for your skin.
- Change the barrier before it leaks, as leaking output can quickly undermine any product.
- Keep consulting with a WOC/ostomy nurse for advice on product combinations and convexity levels.

6. Miscellaneous Tips:
- Warm the adhesive with a hair dryer, especially in cooler rooms.
- Keep a tighter belt on during activity or right after a change.
- Leaks often decrease after the first few months of trial and error, so persistence is key.
See full discusison
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